TY 2018 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) JOSEPH ANDREANA...................................................................... TRUSTEE	0.23 ................. 0.46	X		0	0	0
(2) JOHN AVERSA DO...................................................................... TRUSTEE	0.23 ................. 0.23	X		0	0	0
(3) FREDERICK BROWNE MD...................................................................... TRUSTEE	0.23 ................. 40.23	X		0	457,783	33,032
(4) KENNETH BALDYGA...................................................................... CHAIRMAN	0.23 ................. 0.62	X	X	0	0	0
(5) JOHN W BETKOWSKI III...................................................................... TRUSTEE	0.23 ................. 0.62	X		0	0	0
(6) GREGORY BORIS DO...................................................................... TRUSTEE	0.23 ................. 0.15	X		0	0	0
(7) PATRICK A CHARMEL...................................................................... CEO/PRESIDENT, BOD SECRETARY/TREASURER	45.00 ................. 5.15	X	X	622,266	0	33,032
(8) DONNA DIGIANVITTORIO...................................................................... TRUSTEE	0.23 ................. 0.23	X		0	0	0
(9) NANCY DINARDO...................................................................... TRUSTEE	0.23 ................. 0.38	X		0	0	0
(10) KENNETH J DOBULER MD...................................................................... TRUSTEE/PHYSICIAN	40.00 ................. 0.23	X		337,101	0	8,250
(11) JEAN CRUM JONES MPH RD...................................................................... TRUSTEE	0.23 ................. 0.23	X		0	0	0
(12) THEMIS KLARIDES...................................................................... TRUSTEE	0.23 ................. 0.46	X		0	0	0
(13) GEORGE S LOGAN...................................................................... TRUSTEE	0.23 ................. 0.46	X		0	0	0
(14) GEORGE MITCHELL JR...................................................................... TRUSTEE (FROM 01/2019)	0.23 ................. 0.23	X		0	0	0
(15) FLOYD MOIR...................................................................... TRUSTEE	0.23 ................. 0.23	X		0	0	0
(16) WM NEIL PEARSON MD...................................................................... TRUSTEE	0.23 ................. 0.23	X		0	0	0
(17) MARK PETERSON...................................................................... TRUSTEE	0.23 ................. 0.23	X		0	0	0

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) ROBERT G REISS........................................................................ TRUSTEE (FROM 01/2019)	0.23 .......................0.46	X					0	0
(19) GERALD T WEINER ESQ........................................................................ TRUSTEE	0.23 .......................0.46	X					0	0
(20) PHILLIP WHITE........................................................................ TRUSTEE	0.23 .......................0.23	X					0	0
(21) JOHN J ZAPRZALKA........................................................................ TRUSTEE	0.23 .......................0.46	X					0	0
(22) ALEXANDER S BALKO........................................................................ CFO/VP FINANCE	40.00 .......................		X				180,920	17,260
(23) MARGARET DEEGAN........................................................................ VP	40.00 .......................			X			238,884	30,386
(24) TODD LIU........................................................................ VP	40.00 .......................			X			213,192	30,369
(25) BARBARA STUMPO........................................................................ VP	40.00 .......................			X			229,610	30,904
(26) KATHLEEN MARTIN........................................................................ VP	40.00 .......................			X			211,989	30,333
(27) BENJAMIN ZIGUN........................................................................ PHYSICIAN	40.00 .......................				X		312,877	32,926
(28) STEPHEN MORDECAI........................................................................ PHYSICIAN	40.00 .......................				X		171,319	29,842
(29) MIHAELA BORAN........................................................................ PHYSICIAN	40.00 .......................				X		199,603	28,278
(30) NUMAN GHARAIBEH........................................................................ PHYSICIAN	40.00 .......................				X		247,954	26,562
(31) ADAM DWORKIN........................................................................ VP	40.00 .......................				X		195,668	30,029
(32) MARK O'NEILL RESIGNED 62918........................................................................ FORMER CFO/VP FINANCE	0.00 .......................					X	255,546	5,227

(A) Name and business address	(B) Description of services	(C) Compensation
UNIDINE CORPORATION PO BOX 360639 PITTSBURGH,PA15251	FOOD SERVICE	2,253,237
UMB CAPITAL FINANCE NW 6333 PO BOX 1450 MINNEAPOLIS,MN55485	CONSULTANTS	2,126,242
ASCENSION HEALTH ALLIANCE PO BOX 505302 ST LOUIS,MO63105	PURCHASING CONSULTANTS	743,949
CONNECTICUT EMERGENCY MEDICINE 2909 BERLIN TURNPIKE NEWINGTON,CT06111	MEDICAL CONSULTANTS	489,708
QUEST DIAGNOSTICS PO BOX 844217 BOSTON,MA02284	LAB SERVICES	447,467
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 23

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

GRIFFIN HOSPITAL

Employer identification number

06-0647014

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2018

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2018 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2017 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2018. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2017. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2017. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2018

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2018 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2017 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2018 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2017 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2018. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2017. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2018

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2018

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2018

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2018

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2018 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2018	(iii) Distributable Amount for 2018
1 Distributable amount for 2018 from Section C, line 6
2 Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2018:
a From 2013.......
b From 2014.......
c From 2015.......
d From 2016.......
e From 2017.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2018 distributable amount
i Carryover from 2013 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2018 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2018 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2018, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2018. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2019. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2014......
b Excess from 2015.....
c Excess from 2016.....
d Excess from 2017.....
e Excess from 2018.....

Schedule A (Form 990 or 990-EZ) (2018)

Schedule A (Form 990 or 990-EZ) 2018

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Name of the organization

GRIFFIN HOSPITAL

Employer identification number

06-0647014

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution. An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2

Name of organization GRIFFIN HOSPITAL

Part I	Contributors (See instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 3

Name of organization GRIFFIN HOSPITAL		Employer identification number 06-0647014

Part II	Noncash Property (See instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 4


Name of organization GRIFFIN HOSPITAL			Employer identification number 06-0647014
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

GRIFFIN HOSPITAL

Employer identification number

06-0647014

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2018

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ...............................
c	Total lobbying expenditures (add lines 1a and 1b) ...................................................................
d	Other exempt purpose expenditures ........................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2018

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

18,717

Total. Add lines 1c through 1i ....................................................................................................

18,717

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures (see instructions) .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
PART II-B, LINE 1:	THE GRIFFIN HOSPITAL PAID FOR MEMBERSHIP DUES TO THE CONNECTICUT HOSPITAL ASSOCIATION. FOR THE FISCAL YEAR ENDED 9/30/2019, $18,717 OF THE MEMBERSHIP DUES PAID WAS USED FOR LOBBYING ON ISSUES RELEVANT TO THE ORGANIZATION'S EXEMPT PURPOSE.

Schedule C (Form 990 or 990EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

GRIFFIN HOSPITAL

Employer identification number

06-0647014

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2018

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....	3,820,586	3,579,131	3,279,717	3,400,689	3,517,730
b	Contributions ...
c	Net investment earnings, gains, and losses	179,083	247,455	301,914	252,030	-117,041
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	4,000	6,000	2,500	373,002
f	Administrative expenses ....
g	End of year balance ......	3,995,669	3,820,586	3,579,131	3,279,717	3,400,689

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

0 %

Permanent endowment SchDMd Bullet

54.070 %

Temporarily restricted endowment SchDMd Bullet

45.930 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations .................

3a(i)

Yes

(ii) related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	4,027,891		4,027,891
b	Buildings ....	82,132,143	46,377,643	35,754,500
c	Leasehold improvements
d	Equipment ....	88,022,221	68,561,626	19,460,595
e	Other .....	2,789,892	1,088,391	1,701,501
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				60,944,487

Schedule D (Form 990) 2018

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1)INTEREST IN NET ASSETS OF AFFILIATE	9,105,297	C
(2)INVESTMENT IN AFFILIATE	2,970,366	C
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)	12,075,663

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1) OTHER RECEIVABLES				1,367,680
(2) DUE FROM AFFILIATES				9,073,529
(3) OTHER ASSETS & INSURANCE RECOVERABLE				3,534,923
(4) DEBT ISSUANCE COSTS				368,760
(5) ACCRUED INTEREST RECEIVABLE				54,038
(6) ESTIMATED THIRD PARTY SETTLEMENTS				245,582
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				14,644,512

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
ACCRUED POSTRETIREMENT BENEFIT LIABILITY	10,187,739
PROFESSIONAL AND GENERAL LIABILITY LOSS RESERVES	2,985,966
ACCRUED PENSION LIABILITY	38,251,355
WORKERS COMPENSATION LOSS RESERVES	1,846,338
ACCRUED INTEREST PAYABLE	208,673
CONDITIONAL ASSET RETIREMENT OBLIGATIONS	95,831
ESTIMATED THIRD-PARTY SETTLEMENTS	4,994,439
DUE TO AFFILIATES	276,634
CAPITAL LEASE OBLIGATIONS	3,878,375
INTEREST RATE SWAP AGREEMENTS	390,828
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	63,116,178
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2018

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	202,321,061
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	-1,229,317
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................			2e	-1,229,317
3	Subtract line 2e from line 1..................			3	203,550,378
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................			4c	0
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	203,550,378

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1	193,983,136
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e	0
3	Subtract line 2e from line 1...................		3	193,983,136
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c	0
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5	193,983,136

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference

Explanation

PART V, LINE 4:

THE HOSPITAL'S ENDOWMENT FUNDS CONSIST OF DONOR RESTRICTED FUNDS TO BE INVESTED IN PERPETUITY TO PROVIDE A PERMANENT SOURCE OF INCOME.

PART X, LINE 2:

BELOW IS AN EXCERPT FROM FOOTNOTE 1 OF THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS FOR THE GRIFFIN HOSPITAL AND SUBSIDIARY. THE HOSPITAL AND GFP ARE NOT-FOR-PROFIT ORGANIZATIONS, EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE HOSPITAL AND GFP ACCOUNT FOR UNCERTAINTY IN INCOME TAX POSITIONS BY APPLYING A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2019, THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE HOSPITAL AND GFP ARE SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS. THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS PENDING OR IN PROGRESS. DURING 2019, THE IRS CONDUCTED AN EXAMINATION OF THE HOSPITAL'S FORM 990 AND 990T FOR THE YEAR ENDED SEPTEMBER 30, 2016 AND THE RETURNS WERE ACCEPTED AS FILED.

Schedule D (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

GRIFFIN HOSPITAL

Employer identification number

06-0647014

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other 25000.0000000000 %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .		154	1,063,058		1,063,058	0.560 %
b	Medicaid (from Worksheet 3, column a) . . . . .			24,052,267	16,190,582	7,861,685	4.120 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .		154	25,115,325	16,190,582	8,924,743	4.680 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	14	83,880	1,046,281	162,114	884,167	0.460 %
f	Health professions education (from Worksheet 5) . . .	1		9,022,835	7,319,747	1,703,088	0.890 %
g	Subsidized health services (from Worksheet 6) . . . .	1		9,921,017	6,890,596	3,030,421	1.590 %
h	Research (from Worksheet 7) .	1	0	998,528	719,250	279,278	0.150 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	3	1,839	245,809	0	245,809	0.130 %
j	Total. Other Benefits . .	20	85,719	21,234,470	15,091,707	6,142,763	3.220 %
k	Total. Add lines 7d and 7j .	20	85,873	46,349,795	31,282,289	15,067,506	7.900 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2018

Schedule H (Form 990) 2018

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

816,998

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

61,671,938

Enter Medicare allowable costs of care relating to payments on line 5.....

68,367,819

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-6,695,881

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2018

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	GRIFFIN HOSPITAL 130 DIVISION STREET DERBY,CT06418 WWW.GRIFFINHEALTH.ORG 34	X	X	X	X	X

Schedule H (Form 990) 2018

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	GRIFFIN HOSPITAL
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 18

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): WWW.GRIFFINHEALTH.ORG

Other website (list url): SEE PART V, PAGE 8

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 16

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE PART V, PAGE 8

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2018

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	GRIFFIN HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 250.000000000000% and FPG family income limit for eligibility for discounted care of 400.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE PART V, PAGE 8

The FAP application form was widely available on a website (list url):

SEE PART V, PAGE 8

A plain language summary of the FAP was widely available on a website (list url):
SEE PART V, PAGE 8

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 6

Part VFacility Information (continued)

Billing and Collections

	GRIFFIN HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs

Made a reasonable effort to orally notify individuals about the FAP and FAP application process

Processed incomplete and complete FAP applications

Made presumptive eligibility determinations

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	GRIFFIN HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2018

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
GRIFFIN HOSPITAL	PART V, SECTION B, LINE 5: IN ORDER TO GATHER INPUT FROM PUBLIC HEALTH AND THE GENERAL PUBLIC, GRIFFIN HOSPITAL PARTICIPATED IN THE CREATION OF THE 2019 VALLEY COMMUNITY INDEX. THE 2019 VALLEY COMMUNITY INDEX WAS CREATED IN PARTNERSHIP WITH DATA HAVEN. THIS REPORT REFLECTS THE MOST RECENT DATA COLLECTION EFFORTS TO EXAMINE THE SOCIAL, ECONOMIC, AND PHYSICAL HEALTH OF THE VALLEY AND CONTINUES WHERE THE 2016 COMMUNITY INDEX REPORT LEFT OFF. REGIONAL LEADERS FROM A RANGE OF MULTIDISCIPLINARY ORGANIZATIONS HAVE COME TOGETHER TO EXAMINE WHAT HAS OCCURRED IN THE VALLEY IN THE LAST THREE YEARS. GRIFFIN HEALTH HAS STRONG AND LONGSTANDING PARTNERSHIPS WITH OTHER ORGANIZATIONS AND SOCIAL SERVICE AGENCIES IN THE REGION, INCLUDING THE NAUGATUCK VALLEY HEALTH DISTRICT, THE COMMUNITY BASED VALLEY COUNCIL FOR HEALTH AND HUMAN SERVICES, THE ALLIANCE FOR PREVENTION & WELLNESS, THE VALLEY UNITED WAY, TEAM, INC. ("TEAM"), AND THE VALLEY COMMUNITY FOUNDATION. THE CHNA HELPED INFORM THE COMMUNITY HEALTH IMPROVEMENT PLAN, WHICH WAS DEVELOPED JOINTLY BY GRIFFIN AND THE NAUGATUCK VALLEY HEALTH DEPARTMENT TO OUTLINE THE KEY HEALTH IMPROVEMENT INITIATIVES ADOPTED BY BOTH ORGANIZATIONS FOR THE UPCOMING THREE-YEAR PERIOD.GRIFFIN HEALTH IS COMMITTED TO DEVELOPING COMPREHENSIVE POPULATION HEALTH MANAGEMENT CAPABILITIES INCLUDING A COMMITMENT TO IDENTIFY SOCIAL NEEDS THAT IMPACT THE WELLBEING OF INDIVIDUALS WHO ACCESS THE HEALTHCARE SYSTEM. SCREENING ACTIVITIES IN THE HOSPITAL'S EMERGENCY DEPARTMENT AND OUTPATIENT PHYSICIAN OFFICES HAVE PROMPTED GRIFFIN TO WORK WITH TEAM AND OTHER COMMUNITY BASED ORGANIZATIONS TO DEVELOP STRATEGIES TO ADDRESS FOOD INSECURITY, HOUSING ISSUES, AND TRANSPORTATION NEEDS THAT SIGNIFICANTLY AFFECT THE HEALTH OF INDIVIDUALS. GRIFFIN AND TEAM ARE LEADING EFFORTS TO ELIMINATE HUNGER IN THE REGION AND EDUCATE PEOPLE, PARTICULARLY THOSE WITH CHRONIC DISEASE BURDEN, ABOUT THE ADVERSE IMPACT THAT POOR NUTRITION CAN HAVE ON HEALTH. AS PART OF THAT EFFORT, GRIFFIN HAS PLEDGED $50,000 PER YEAR TO SUBSIDIZE THE COST OF PURCHASING FOOD THAT WILL SUPPLEMENT THE DONATIONS RECEIVED BY LOCAL FOOD PANTRIES THAT SERVE THE REGION.
GRIFFIN HOSPITAL	PART V, SECTION B, LINE 6B: GRIFFINS CHNA WAS CONDUCTED WITH MANY DIFFERENT ORGANIZATIONS. TO UNDERSTAND THE VALLEY REGION, THE 2019 VALLEY COMMUNITY INDEX WAS PRODUCED BY THE VALLEY COMMUNITY FOUNDATION AND DATA HAVEN, OCTOBER 2019.THIS REPORT REFLECTS THE MOST RECENT DATA COLLECTION EFFORTS TO EXAMINE THE SOCIAL, ECONOMIC, AND PHYSICAL HEALTH OF THE VALLEY AND CONTINUES WHERE THE 2016 COMMUNITY INDEX REPORT LEFT OFF. LISTED BELOW ARE THE REGIONAL LEADERS FROM A RANGE OF MULTIDISCIPLINARY ORGANIZATIONS WHICH HAVE COME TOGETHER TO EXAMINE WHAT HAS OCCURRED IN THE VALLEY IN THE LAST THREE YEARS:- DATAHAVEN- VALLEY COMMUNITY FOUNDATION, INC.- BASSETT FAMILY FUNDGRIFFIN HEALTH SERVICES, INC- CONNECTICUT COMMUNITY FOUNDATION- KATHARINE MATTHIES FOUNDATION- THE COMMUNITY FOUNDATION FOR GREATER NEW HAVEN- VALLEY UNITED WAY- NAUGATUCK VALLEY COUNCIL OF GOVERNMENTS- VALLEY COMMUNITY INDEX ADVISORY COMMITTEE- ALLIANCE FOR PREVENTION & WELLNESS- THE VALLEY COUNCIL FOR HEALTH & HUMAN SERVICES- ANSONIA YOUTH SERVICES BUREAU- MUNICIPAL GOVERNMENTS AND SCHOOL DISTRICTS THROUGHOUT THE VALLEY- AREA CONGREGATIONS- ACT-SPOONER HOUSE- BH CARE- BOYS & GIRLS CLUB OF THE LOWER NAUGATUCK VALLEY- CENTER STAGE THEATR- DERBY NECK LIBRARY- DERBY PUBLIC LIBRARY- DERBY YOUTH SERVICES BUREAU- GREATER VALLEY CHAMBER OF COMMERCE- VALLEY COMMUNITY- HOUSATONIC COUNCIL- NAUGATUCK ECONOMIC DEVELOPMENT CORPORATION- NAUGATUCK VALLEY COUNCIL OF GOVERNMENTS- NAUGATUCK VALLEY HEALTH DISTRICT- NAUGATUCK YMCA- PARENT CHILD RESOURCE CENTER- SHELTON ECONOMIC DEVELOPMENT CORPORATION- TEAM, INC.- VALLEY PARISH NURSE PROGRAM- GRIFFIN HOSPITAL- VALLEY UNITED WAY- THE WORKPLACE, INC.- YALE-GRIFFIN PREVENTION RESEARCH CENTERGRIFFIN HOSPITAL:PART V, SECTION B, LINE 7B: WWW.GRIFFINHEALTH.ORG/PORTALS/0/DOCUMENTS/2019-VALLEY-COMMUNITY-INDEX.PDFGRIFFIN HOSPITAL:PART V, SECTION B, LINE 10A: WWW.GRIFFINHEALTH.ORG/PORTALS/0/DOCUMENTS/2019-CHIP.PDF
GRIFFIN HOSPITAL	PART V, SECTION B, LINE 11: GRIFFIN HOSPITAL HAS THREE MAIN FOCUS AREAS: BEHAVIORAL HEALTH; HEART HEALTH; AND MATERAL AND INFANT HEALTH. GRIFFIN HOSPITAL HAS DEVELOPED SPECIFIC GOALS FOR EACH FOCUS AREA. THE HOSPITAL REALIZES THAT THERE ARE OTHER NEEDS IN THE COMMUNITY BUT THEY ARE NOT ABLE TO MEET ALL THE NEEDS DUE TO FINANCIAL AND TIME CONSTRAINTS.FOCUS AREA 1 BEHAVIORAL HEALTH:BEHAVIORAL HEALTH DISORDERS INCLUDE BOTH MENTAL ILLNESS AND SUBSTANCE USE DISORDERS. THIS FOCUS IS ALIGNED WITH TWO SECTIONS OF HEALTHY CT 2020, THE STATE HEALTH IMPROVEMENT PLAN: INJURY AND VIOLENCE PREVENTION AND MENTAL HEALTH, ALCOHOL, AND SUBSTANCE ABUSE. GOAL 1: TO INCREASE BEHAVIORAL HEALTH EDUCATION AND AWARENESS WHILE EMPHASIZING THE IMPORTANCE OF SOCIAL AND EMOTIONAL WELLNESS AND REDUCING STIGMA.GOAL 2: TO REDUCE STRESS, ANXIETY, AND TRAUMA, ESPECIALLY IN YOUNG PEOPLE.GOAL 3: TO REDUCE SUBSTANCE USE DISORDERS IN THE REGION AND PROMOTE A RECOVERY COMMUNITY FOR THOSE WITH SUBSTANCE USE DISORDERS IN THEIR FAMILIES THROUGH EDUCATION ANDAWARENESS. ALIGNMENT WITH THE STATE HEALTH IMPROVEMENT PLAN.FOCUS AREA 2 HEART HEALTH:DATA FROM THE 2019 COMMUNITY INDEX SHOW THAT HEART DISEASE CONTINUES TO BE A LEADING CAUSE OF PREMATURE DEATH IN THE VALLEY.GOAL 1: TO REDUCE PREMATURE DEATH RATES DUE TO HEART DISEASE IN THE NAUGATUCK VALLEY ALIGNMENT WITH THE STATE HEALTH IMPROVEMENT PLAN THE CHIP HEART DISEASE PRIORITY AREA IS ALIGNED WITH THE CHIP'S CHRONIC DISEASE PREVENTION AND CONTROL SECTION OF HEALTHY CT 2020, WHICH AIMS TO REDUCE THE PREVALENCE AND BURDEN OF CHRONIC DISEASE THROUGH SUSTAINABLE, EVIDENCE-BASED EFFORTS AT RISK REDUCTION AND EARLY INTERVENTION.FOCUS AREA 3 MATERNAL AND INFANT:THE COMBINED FETAL AND INFANT MORTALITY RATE IN LOWER NAUGATUCK VALLEY (LNV) IS TRENDING UP, THOUGH THE TREND IS DECREASING IN CT OVERALL MATERNAL AND INFANT HEALTH RISKS CONTRIBUTE TO THE INCIDENCE OF MANY CHRONIC DISEASES IN CHILDHOOD AND ADULTHOOD. ALIGNMENT WITH THE STATE HEALTH IMPROVEMENT PLAN THIS FOCUS IS ALIGNED WITH THE MATERNAL CHILD AND INFANT SECTION OF HEALTHY CT 2020, THE STATE HEALTH IMPROVEMENT PLAN. IT RELATES TO THE FOLLOWING SPECIFIC STATE OBJECTIVES: MICH-2 (PRECONCEPTION HEALTH), MICH-3 (1ST TRIMESTER CARE), MICH-4 (ADEQUATE PRENATAL CARE), MICH-5 (LOW BIRTH WEIGHT), MICH-7 (INFANT MORTALITY), MICH-8 (INFANT MORTALITY DISPARITIES).GOAL 1: TO DECREASE LOW BIRTH WEIGHT AND FETAL/INFANT MORTALITY BY IMPROVING HEALTH BEHAVIORS AMONG PREGNANT AND NON-PREGNANT WOMEN OF CHILDBEARING AGE.GOAL 2: TO INCREASE ADEQUACY OF PRENATAL CARE RECEIVED BY PREGNANT WOMEN BY EMPOWERING WOMEN OF CHILDBEARING AGE TO HAVE PLANNED, HEALTHY PREGNANCIES.GOAL 3: TO REDUCE DISPARITIES IN ADEQUACY OF PRENATAL CARE, LOW BIRTH WEIGHT, AND FETAL/INFANT MORTALITY EXPERIENCED BY RACIAL, ETHNIC, AND SOCIOECONOMIC GROUPS.
GRIFFIN HOSPITAL	PART V, SECTION B, LINE 13H: INVESTMENT, IRA, CHECKING ACCT, REAL ESTATE
GRIFFIN HOSPITAL	PART V, LINE 16A, FAP WEBSITE:HTTPS://WWW.GRIFFINHEALTH.ORG/GRIFFIN-HOSPITAL/BILLING-INSURANCE/FINANCIAL-ASSISTANCE-PROGRAM
GRIFFIN HOSPITAL	PART V, LINE 16B, FAP APPLICATION WEBSITE:HTTPS://WWW.GRIFFINHEALTH.ORG/GRIFFIN-HOSPITAL/BILLING-INSURANCE/FINANCIAL-ASSISTANCE-PROGRAM
GRIFFIN HOSPITAL	PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE:HTTPS://WWW.GRIFFINHEALTH.ORG/GRIFFIN-HOSPITAL/BILLING-INSURANCE/FINANCIAL-ASSISTANCE-PROGRAM

Schedule H (Form 990) 2018

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?4
Name and address		Type of Facility (describe)
1	1 - GRIFFIN IMAGING & DIAGNOSTICS CENTER 2 IVY BROOK ROAD SUITE 130 SHELTON,CT06484	IMAGING CENTER
2	2 - GRIFFIN HOSP OCCUPATIONAL MEDICINE CTR 10 PROGRESS DRIVE SHELTON,CT06484	OCCUPATIONAL MEDICINE
3	3 - GRIFFIN HOSPITAL BLOOD DRAWING STATION 22 WAKEFIELD AVENUE ANSONIA,CT06418	BLOOD DRAWING STATION
4	4 - CHARGER HEALTH CENTER 20 PULASKI HIGHWAY ANSONIA,CT06401	SCHOOL BASED HEALTH CENTER
5
6
7
8
9
10

Schedule H (Form 990) 2018

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
PART I, LINE 3C:	GRIFFIN HOSPITAL CRITERIA FOR DETERMINING ELIGIBILITY FOR FREE CARE OR DISCOUNTED CARE INCLUDE ELIGIBILITY REQUIREMENTS ALL GUARANTORS WITH FAMILY INCOME EQUAL TO OR BELOW TWO HUNDRED PERCENT OF THE FEDERAL POVERTY STANDARD ADJUSTED FOR FAMILY SIZE SHALL BE DETERMINED TO BE INDIGENT PERSONS QUALIFYING FOR CHARITY SPONSORSHIP FOR THE FULL AMOUNT OF HOSPITAL CHARGES RELATED TO APPROPRIATE HOSPITAL-BASED MEDICAL SERVICES THAT ARE NOT COVERED BY PRIVATE OR PUBLIC THIRD-PARTY SPONSORSHIP. ALL GUARANTORS WITH FAMILY INCOME BETWEEN TWO HUNDRED FIFTY (250%) AND FOUR HUNDRED PERCENT (400%) OF THE FEDERAL POVERTY STANDARD ADJUSTED FOR FAMILY SIZE SHALL BE DETERMINED TO BE INDIGENT PERSONS QUALIFYING FOR DISCOUNTS FROM CHARGES RELATED TO APPROPRIATE HOSPITAL BASED MEDICAL SERVICES IN ACCORDANCE WITH THE SLIDING FEE SCHEDULE AND POLICIES REGARDING INDIVIDUAL FINANCIAL CIRCUMSTANCES BASED ON THE BELOW CRITERIA:(A) ELIGIBILITY SHALL BE BASED ON FINANCIAL NEED AT THE TIME OF APPLICATION BY COMPARING TOTAL FAMILY INCOME WITH THE CURRENT FEDERAL POVERTY GUIDELINES. IF A FAMILY'S TOTAL INCOME IS GREATER THAN 100% OF THE FEDERAL POVERTY GUIDELINE FAMILY ASSETS OTHER THAN EXEMPT ASSETS LISTED BELOW MAY BE CONSIDERED AS A SOURCE OF PAYMENT.(B) EXEMPT ASSETS (BASED ON MEDICARE EXEMPTED ASSETS) LISTED BELOW SHOULD NOT BE ADDED TO FAMILY WORTH FOR CHARITY REVIEW: (I) FAMILY PRINCIPAL RESIDENCE. (II) NECESSARY MOTOR VEHICLES REQUIRED FOR EMPLOYMENT, REQUIRED FOR ACCESS TO TREATMENT, OR MODIFIED FOR OPERATION OR TRANSPORT OF A DISABLED PERSON. (III) PERSONAL EFFECTS AND HOUSEHOLD GOODS. (IV) RESOURCES NECESSARY FOR SELF-SUPPORT. ALL RESOURCES OF BOTH SPOUSES ARE CONSIDERED TOGETHER.(C) CHARITY WILL BE ASSIGNED USING THE MOST RECENTLY PUBLISHED FEDERAL POVERTY STANDARDS AND EVALUATED ON THE ADJUSTED FAMILY INCOME AS EXPLAINED ABOVE FOR THOSE ABOVE 250% OF SUCH STANDARDS.(D) DOCUMENTATION WILL BE REQUESTED AND IN MOST CASES WILL BE REQUIRED TO ESTABLISH ELIGIBILITY FOR CHARITY CARE. IN THE EVENT THAT THE GUARANTOR IS NOT ABLE TO PROVIDE THE DOCUMENTATION DESCRIED ABOVE, THE HOSPITAL SHALL RELY UPON WRITTEN AND SIGNED STATEMENTS FORM THE GUARANTOR TO MAKE A FINAL DETERMINATION OF ELIGIBILITY FOR CLASSIFICATION AS AN INDIGENT PERSON.
PART I, LINE 6A:	GRIFFIN HOSPITAL CONSTANTLY UPDATES THEIR WEBSITE WITH THE MOST CURRENT COMMUNITY BENEFIT REPORTING.PART I, LINE 6B:GRIFFIN HOSPITAL POSTS ITS COMMUNITY BENEFIT REPORT AND INFORMATION ON THE HOSPITAL WEBSITE:HTTPS://WWW.GRIFFINHEALTH.ORG/ABOUT-GRIFFIN/COMMUNITY-BENEFIT-REPORT/CHNA
PART I, LINE 7:	CHARITY CARE AND OTHER COMMUNITY BENEFITS TABLE WERE CALCULATED USING A COST ACCOUNTING SYSTEM OR COST TO CHARGE RATIO. THE COST ACCOUNTING SYSTEM ADDRESSES ALL PATIENT SEGMENTS AND ASSIGNS COST TO INDIVIDUAL SERVICES.
PART I, LINE 7, COLUMN (F):	THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 3,038,213.
PART III, LINE 2:	GRIFFIN HOSPITAL BAD DEBT EXPENSE IS DETERMINED USING UNCOLLECTED ACCOUNTS NET OF ANY BAD DEBT RECOVERY MULTIPLIED BY THE COST TO CHARGE RATIO. GRIFFIN HOSPITAL HAS A WRITTEN POLICY ABOUT WHEN AND UNDER WHOSE AUTHORITY PATIENT DEBT IS ADVANCED FOR COLLECTION AND SHALL USE ITS BEST EFFORTS TO ENSURE THAT THE PATIENT ACCOUNTS ARE PROCESSED FAIRLY AND CONSISTENTLY. CHARITY APPROVAL WILL AFFECT ALL ACCOUNTS FOR WHICH THE APPROVED GUARANTOR IS RESPONSIBLE. THE APPROVED CHARITY PERCENTAGE WILL BE APPLIED TO ALL EXISTING ACCOUNTS WITH DEBIT BALANCES. ACCOUNTS MAY ALSO BE RETURNED FROM BAD DEBT STATUS IF FINANCIAL CIRCUMSTANCES WARRANT AND CHARITY MAY BE APPLIED. THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS FREE CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAT IT'S ESTABLISHED AND CONTRACTUAL RATES. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS FREE CARE, THEY ARE NOT REPORTED AS NET PATIENT SERVICE REVENUE.
PART III, LINE 3:	GRIFFIN HOSPITAL DOES NOT ATTRIBUTE ANY BAD DEBT TO COMMUNITY BENEFIT EXPENSE. UNCOLLECTED BALANCES ARE REVIEWED AT MANY STAGES TO DETERMINE IF THEY FALL UNDER UNINSURED OR FREE CARE ASSISTANCE.
PART III, LINE 4:	GRIFFIN HOSPITAL AND SUBSIDIARY NOTES TO CONSOLIDATED FINANCIAL STATEMENTS SEPTEMBER 30, 2019.ALLOWANCE FOR DOUBTFUL ACCOUNTS (PAGE 17)THE HOSPITAL'S ESTIMATION OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS BASED PRIMARILY UPON THE TYPE AND AGE OF THE PATIENT ACCOUNTS RECEIVABLE AND THE EFFECTIVENESS OF THE HOSPITAL'S COLLECTION EFFORTS. THE HOSPITAL'S POLICY IS TO RESERVE A PORTION OF ALL SELF-PAY RECEIVABLES, INCLUDING AMOUNTS DUE FROM THE UNINSURED AND AMOUNTS RELATED TO CO-PAYMENTS AND DEDUCTIBLES, AS THE CHARGES ARE RECORDED. ON A MONTHLY BASIS, THE HOSPITAL REVIEWS ITS ACCOUNTS RECEIVABLE BALANCES, THE EFFECTIVENESS OF THE HOSPITAL'S RESERVE POLICIES AND VARIOUS ANALYTICS TO SUPPORT THE BASIS FOR ITS ESTIMATES. THESE EFFORTS PRIMARILY CONSIST OF REVIEWING THE FOLLOWING: REVENUE AND VOLUME TRENDS BY PAYOR, PARTICULARLY THE SELF-PAY COMPONENTS; CHANGES IN THE AGING AND PAYOR MIX OF ACCOUNTS RECEIVABLE, INCLUDING INCREASED FOCUS ON ACCOUNTS DUE FROM THE UNINSURED AND ACCOUNTS THAT REPRESENT CO-PAYMENTS AND DEDUCTIBLES DUE FROM PATIENTS; VARIOUS ALLOWANCE COVERAGE STATISTICS. THE HOSPITAL REGULARLY PERFORMS HINDSIGHT PROCEDURES TO EVALUATE HISTORICAL WRITE-OFF AND COLLECTION EXPERIENCE THROUGHOUT THE YEAR TO ASSIST IN DETERMINING THE REASONABLENESS OF ITS PROCESS FOR ESTIMATING THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.MEASURING CHARITY CARE (PAGES 17 & 18)THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS FREE CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED AND CONTRACTUAL RATES. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS FREE CARE, THEY ARE NOT REPORTED AS NET PATIENT SERVICE REVENUE. A PATIENT IS CLASSIFIED AS A CHARITY PATIENT BY REFERENCE TO THE ESTABLISHED POLICIES OF THE HOSPITAL. ESSENTIALLY, THESE POLICIES DEFINE CHARITY SERVICES AS THOSE SERVICES FOR WHICH NO PAYMENT IS POSSIBLE. IN ASSESSING A PATIENT'S INABILITY TO PAY, THE HOSPITAL UTILIZES THE GENERALLY RECOGNIZED FEDERAL POVERTY INCOME LEVELS, BUT ALSO INCLUDES CERTAIN CASES WHERE INCURRED CHARGES ARE SIGNIFICANT WHEN COMPARED TO INCOMES AND ASSETS. SELF-PAY REVENUES ARE DERIVED PRIMARILY FROM PATIENTS WHO DO NOT HAVE ANY FORM OF HEALTH CARE COVERAGE. THE HOSPITAL EVALUATES THESE PATIENTS, AFTER THE PATIENT'S MEDICAL CONDITION IS DETERMINED TO BE STABLE, FOR THEIR ABILITY TO PAY BASED UPON FEDERAL AND STATE POVERTY GUIDELINES, QUALIFICATIONS FOR MEDICAID OR OTHER GOVERNMENTAL ASSISTANCE PROGRAMS, AS WELL AS THE HOSPITAL'S POLICY FOR CHARITY CARE. FOR THE YEARS ENDED SEPTEMBER 30, 2019 AND 2018, THE HOSPITAL ESTIMATES THAT ITS COSTS OF CARE PROVIDED UNDER ITS CHARITY CARE PROGRAMS APPROXIMATED $1,098,000 AND $1,002,000, RESPECTIVELY.THE HOSPITAL'S MANAGEMENT ESTIMATES ITS COSTS OF CARE PROVIDED UNDER ITS CHARITY CARE PROGRAMS UTILIZING A CALCULATED RATIO OF COSTS TO GROSS CHARGES MULTIPLIED BY THE HOSPITAL'S GROSS CHARITY CARE CHARGES PROVIDED. THE HOSPITAL'S GROSS CHARITY CARE CHARGES INCLUDE ONLY SERVICES PROVIDED TO PATIENTS WHO ARE UNABLE TO PAY AND QUALIFY UNDER THE HOSPITAL'S CHARITY CARE POLICY. TO THE EXTENT THE HOSPITAL RECEIVES REIMBURSEMENT THROUGH THE VARIOUS GOVERNMENTAL ASSISTANCE PROGRAMS IN WHICH IT PARTICIPATES TO SUBSIDIZE ITS CARE OF INDIGENT PATIENTS, THE HOSPITAL DOES NOT INCLUDE THESE PATIENTS' CHARGES IN ITS COST OF CARE PROVIDED UNDER ITS CHARITY CARE PROGRAM. ADDITIONALLY, THE HOSPITAL DOES NOT REPORT A CHARITY CARE PATIENT'S CHARGES IN REVENUES OR IN THE PROVISION FOR DOUBTFUL ACCOUNTS AS IT IS THE HOSPITAL'S POLICY NOT TO PURSUE COLLECTION OF AMOUNTS RELATED TO THESE PATIENTS.
PART III, LINE 8:	GRIFFIN HOSPITAL BELIEVES THAT ALL OF THE $6,696 MILLION SHORTFALL SHOULD BE CONSIDERED AS COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. THIS YEAR MEDICARE ACCOUNTED FOR 3.4 % OF HOSPITAL EXPENSES THE HOSPITAL PROVIDES CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVES THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES.
PART III, LINE 9B:	THE HOSPITAL PROVIDES A PLAIN LANGUAGE SUMMARY IN CLEAR CONCISE AND EASY TO UNDERSTAND WRITTEN STATEMENT THAT THE HOSPITAL USES TO NOTIFY A PATIENT AND /OR APPLICABLE RESPONSIBLE INDIVIDUALS THAT THE HOSPITAL OFFERS FINANCIAL ASSISTANCE UNDER THE FAP FOR COVERED SERVICES PROVIDED BY THE HOSPITAL. FAP PLAIN LANGUAGE SUMMARY WEBSITE: WWW.GRIFFINHEALTH.ORG/GRIFFIN-HOSPITAL/BILLING-INSURANCE/FINANCIAL-ASSISTANCE-PROGRAM
PART VI, LINE 2:	GRIFFIN HOSPITAL, REALIZED THAT THERE ARE MANY DIRECTIONS THAT REACH OUT TO WHERE, FROM A POPULATION HEALTH STANDPOINT, NEED TO BE ADDRESSED. WORKING COLLABORATIVELY WITH THE NAUGATUCK VALLEY HEALTH DISTRICT, THE VALLEY COUNCIL FOR HEALTH AND HUMAN SERVICES, THE ALLIANCE FOR PREVENTION & WELLNESS (FORMERLY VSAAC), AND OUR VALLEY PARISH NURSES COMMUNITY OUTREACH PROGRAM, WE PROACTIVELY ADDRESS ISSUE AREAS SUCH AS CHILDHOOD OBESITY, EARLY DETECTION SCREENING FOR CANCER, CHILDHOOD ASTHMA, AND SUBSTANCE ABUSE PREVENTION. AS A VALLEY COMMUNITY, WE HAVE ALWAYS BEEN UNIQUELY CONNECTED, WITH A SPIRIT OF COOPERATION AND COLLECTIVE WILL TO MAKE THINGS BETTER. NOW, BY LOOKING AT OUR SEVEN VALLEY TOWNS THROUGHOUT THIS REPORT, TAKING INTO CONSIDERATION EDUCATION, HOUSING, EMPLOYMENT, RECREATION, EARLY CHILDHOOD DEVELOPMENT, AND AGING ISSUES IN ADDITION TO HEALTH AND HEALTHIER LIFESTYLES, WE ARE SEEING A MUCH BROADER AND MORE COMPREHENSIVE PICTURE THAN EVER BEFORE. THIS INDEX SERVES AS THE AERIAL VIEW FROM WHICH WE CAN ZOOM IN ON THE CHALLENGES WE FACE, THE ISSUES WE HOPE TO ADDRESS, AND THE MANY OPPORTUNITIES WE HAVE TO LEVERAGE OUR CONSIDERABLE RESOURCES OVER THE NEXT THREE YEARS TO EFFECT CHANGE AND IMPROVE THE HEALTH OF OUR COMMUNITY.
PART VI, LINE 3:	FINANCIAL ASSISTANCE BROCHURE AND POSTERS ARE LOCATED THROUGHOUT THE HOSPITAL (CHILDBIRTH AREA, ER AREA, CUSTOMER SERVICE AREA) IN ENGLISH AND SPANISH EXPLAINING THE FINANCIAL ASSISTANCE POLICY AND HOW TO CONTACT THE FINANCIAL COUNSELORS. BROCHURES ARE ALSO DISTRIBUTED AT COMMUNITY EVENTS. AT REGISTRATION THE ADMITTING REGISTRAR WHO WILL IDENTIFY THE PATIENT AS HAVING NO MEDICAL INSURANCE (SELF-PAY). THE PATIENT WILL BE GIVEN A FINANCIAL ASSISTANCE PAMPHLET THAT WILL IDENTIFY ALL GRIFFIN HOSPITAL FINANCIAL ASSISTANCE PROGRAMS. THE PAMPHLET ALSO INCLUDES HOSPITAL CONTACTS FOR PATIENTS SEEKING STATE WELFARE OR OTHER STATE PROGRAMS.
PART VI, LINE 4:	GRIFFIN HOSPITAL, LICENSED BY THE STATE OF CONNECTICUT FOR 160 BEDS AND 15 BASSINETS, IS A GENERAL ACUTE CARE HOSPITAL SERVING A PRIMARY SERVICE AREA (PSA) OF SIX TOWNS, THAT COMPRISE THE LOWER NAUGATUCK VALLEY INCLUDING ANSONIA, DERBY, SEYMOUR, SHELTON, OXFORD, BEACON FALLS AND SURROUNDING TOWNS INCLUDING BETHANY, MIDDLEBURY, MILFORD, MONROE, NAUGATUCK, ORANGE, PROSPECT, SOUTHBURY, STRATFORD, TRUMBULL, WOODBRIDGE AND WOODBURY. IN THE VALLEY, ANSONIA, DERBY, AND NAUGATUCK CONTAIN THE DIVERSE NEIGHBORHOODS AND MANUFACTURING LEGACIES THAT ARE COMMON TO URBAN PERIPHERY TOWNS THROUGHOUT THE STATE. BEACON FALLS AND SEYMOUR SHARE SOME OF THE CHARACTERISTICS OF RURAL TOWNS, WHILE OXFORD AND SHELTON ARE MORE TYPICAL OF HIGHER-INCOME SUBURBAN AREAS. GIVEN THIS VARIETY, THE REGION IS A MICROCOSM OF CONNECTICUT AS A WHOLE. THE VALLEY IS A COMMUNITY OF CONNECTICUT TOWNS LOCATED IN NEW HAVEN AND FAIRFIELD COUNTIES. IT LIES ALONG THE HOUSATONIC AND NAUGATUCK RIVERS AND IS CONNECTED TO CITY CENTERS ALONG I-95 BETWEEN NEW YORK AND NEW HAVEN, AS WELL AS ALONG ROUTE 8 TO WATERBURY. WE DEFINE THE VALLEY AS THE SEVEN TOWNS THAT COLLABORATED TO WIN THE ALL-AMERICA CITY AWARD IN THE YEAR 2000: ANSONIA, BEACON FALLS, DERBY, NAUGATUCK, OXFORD, SEYMOUR, AND SHELTON. THE TOWNS SHARE A SPIRITED COMMUNITY CULTURE AND STRONG INSTITUTIONS, WHICH COLLABORATE ON INITIATIVES IN CIVIC VITALITY, HEALTH AND HUMAN SERVICES, ECONOMIC DEVELOPMENT, AND QUALITY OF LIFE. THE COLLABORATIVE WORK IT TOOK BY MANY TO BE RECOGNIZED AS PART OF THE 20-TOWN NAUGATUCK VALLEY CORRIDOR, A FEDERALLY-DESIGNATED ECONOMIC DEVELOPMENT DISTRICT (EDD), IS A PRIME EXAMPLE OF HOW VALLEY LEADERS COME TOGETHER FOR THE GREATER GOOD. THE VALLEY HAS A COMMON HISTORY AND IDENTITY, BUT EACH OF ITS TOWNS HAS ITS OWN UNIQUE CHARACTERISTICS. THE REGION'S DEMOGRAPHICS AND ECONOMY ARE CONSTANTLY CHANGING IN RESPONSE TO OUTSIDE FORCES; THESE CHANGES AFFECT THE REGION'S NEIGHBORHOODS IN DIFFERENT WAYS. TOWN CENTERS OFFER A LARGE SHARE OF RENTAL OR AFFORDABLE HOUSING UNITS, WHICH ARE ATTRACTIVE TO YOUNGER WORKERS, SINGLE ADULTS, AND OTHER HOUSEHOLDS THAT WOULD PREFER TO RENT FOR ECONOMIC OR LIFESTYLE REASONS. IN OTHER NEIGHBORHOODS, NEWER HOMES AND LARGER LOTS CONTINUE TO ATTRACT HOMEOWNERS WITH HIGH INCOMES. THE VARIETY OF NEIGHBORHOODS AND RESIDENTS WHO CHOOSE TO LIVE IN THE AREA HELP MAKE THE VALLEY A RESILIENT COMMUNITY WITH A RICH TRADITION OF IMMIGRATION AND MIGRATION. THE VALLEY'S LEGACY OF AGRICULTURAL AND INDUSTRIAL PRODUCTION ARISES FROM ITS LOCATION ALONG TWO MAJOR RIVERS. TODAY, THE ECONOMY OF THE VALLEY COMMUNITIES IS SIGNIFICANTLY INFLUENCED BY THE CONTINUED DEVELOPMENT ALONG THE ROUTE 8 CORRIDOR, WHICH HAS RESULTED IN BOTH OPPORTUNITIES AND CHALLENGES. SHELTON, IN PARTICULAR, HAS EXPERIENCED NEW COMMERCIAL AND OFFICE DEVELOPMENT BY VIRTUE OF ITS LOCATION AND INFRASTRUCTURE. ITS STRONG FINANCIAL BASE, HOWEVER, CAN MASK THE ECONOMIC CHALLENGES THAT OTHER TOWNS FACE. LEVELS OF PERSONAL WELL-BEING ARE NOT EVENLY DISTRIBUTED ACROSS THE VALLEY'S POPULATION. AN INCREASINGLY DIVERSE POPULATION AND A GROWING NUMBER OF SENIORS PRESENT NEW NEEDS AND OPPORTUNITIES. INCOMES VARY BY TOWN, AND MORE PEOPLE, ESPECIALLY CHILDREN, LIVE IN ECONOMIC HARDSHIP. CANCER, HEART DISEASE, AND ACCIDENTS ARE LEADING CAUSES OF PREMATURE DEATHS. ALMOST HALF OF VALLEY WORKERS EARN LESS WHAT IS CONSIDERED NECESSARY TO COVER COSTS OF LIVING IN THE REGION.
PART VI, LINE 5:	AS A PATIENT-CENTERED HEALTH CARE SYSTEM, GRIFFIN HOSPITAL IS COMMITTED TO PARTNERING WITH OUR COMMUNITY TO PROMOTE WELLNESS THROUGH A WIDE VARIETY OF PROGRAMS AND SERVICES. GRIFFIN-SPONSORED EVENTS AS A PROUD MEMBER OF THE NAUGATUCK VALLEY COMMUNITY, GRIFFIN HOSPITAL WORKS IN TANDEM WITH OTHER COMMUNITY ORGANIZATIONS TO STRENGTHEN OUR CITIZENS, ENCOURAGE POSITIVE RELATIONSHIPS, FACILITATE ONGOING WELLNESS AND PROVIDE ONGOING SUPPORT TO THOSE IN NEEDS. VALLEY PARISH NURSE PROGRAM VALLEY PARISH NURSES SERVE AS COORDINATORS BETWEEN THE CLERGY, PARISH AND RESOURCES IN THE COMMUNITY, SUCH AS HOSPITALS AND OTHER SOCIAL SERVICE AGENCIES. MOBILE HEALTH RESOURCE CENTER- THE GRIFFIN HOSPITAL MOBILE HEALTH RESOURCE VAN IS A CUSTOM BUILT WINNEBAGO THAT TRAVELS TO VARIOUS LOCATIONS THROUGHOUT THE LOWER NAUGATUCK VALLEY, SUCH AS SENIOR CENTERS, SHOPPING CENTERS, NEIGHBORHOODS, COMPANIES AND COMMUNITY EVENTS AND FAIRS. ADVANCE CARE PLANNING PLAN NOW TO ENSURE THAT YOUR WISHES FOR END-OF-LIFE DECISIONS ARE UNDERSTOOD, RESPECTED, AND HONORED BY LOVED ONES AND HEALTHCARE PROVIDERS. HEALTH INITIATIVE FOR MEN (HIM)- THE GOAL OF THE HIM IS TO INFLUENCE MEN TO SEE THEIR PHYSICIAN ANNUALLY, AND TO BE SCREENED FOR VARIOUS DISEASES THAT RESPOND BETTER TO TREATMENT IF DETECTED EARLY. VALLEY WOMEN'S HEALTH INITIATIVE THE VALLEY WOMEN'S HEALTH INITIATIVE (WHI) IS COMPRISED OF MEMBERS OF THE COMMUNITY WORKING TOWARD A COMMON GOAL OF ADDRESSING AND IMPROVING WOMEN'S HEALTH ISSUES INCLUDING BREAST CANCER AWARENESS AND HEART DISEASE. WOMEN'S HEART WELLNESS COMMITTEE A COMMUNITY INITIATIVE FOCUSED ON EDUCATION, OUTREACH, AND PREVENTION. HEALTH RESOURCE CENTER - THE COMMUNITY HEALTH RESOURCE CENTER (HRC) AT GRIFFIN HOSPITAL IS A TRADITIONAL FREE LENDING LIBRARY THAT PROVIDES AN ARRAY OF MEDICAL AND HEALTH INFORMATION. HEALTHY U EDUCATIONAL SERIES HEALTHY U IS A SERIES OF WELLNESS TALKS FEATURING GRIFFIN HOSPITAL MEDICAL EXPERTS AND COMMUNITY PARTNERS PROVIDING TRUSTED HEALTH INFORMATION AND ANSWERS TO QUESTIONS ON A WIDE RANGE OF TOPICS. ALL TALKS ARE FREE AND OPEN TO THE PUBLIC. MINI MED SCHOOL FREE PROGRAM FOR THE LAYPERSON WITH LITTLE OR NO MEDICAL BACKGROUND, PROVIDING A UNIQUE OPPORTUNITY TO GAIN A GREATER UNDERSTANDING OF HOW THE HUMAN BODY WORKS, INSIGHT INTO COMMON DISORDERS OF THE VARIOUS ORGAN SYSTEMS, AS WELL AS INFORMATION ABOUT DISEASE PREVENTION. PERSONAL EMERGENCY PREPAREDNESS GRIFFIN HOSPITAL DEPARTMENT OF EMERGENCY MANAGEMENT (EM) HELPS TO PREPARE THE COMMUNITY IN CASE OF A DISASTER OR EMERGENCY SITUATION. THIS PAGE PROVIDES SAFETY AND PREPAREDNESS TIPS AS WELL AS IMPORTANT LOCAL AND GOVERNMENTAL CONTACTS. PLANETREE WELLNESS EDUCATION SERIES GRIFFIN HOSPITAL'S PLANETREE EDUCATION IS PROUD TO OFFER THIS FREE HEALTH EMPOWERMENT SERIES OF FUN AND EDUCATIONAL TALKS FOR MEMBERS OF OUR COMMUNITY. SAFE KIDS GRIFFIN HOSPITAL'S SAFE KIDS GREATER NAUGATUCK VALLEY COALITION IS AVAILABLE TO EDUCATE CHILDREN AND ADULTS ON VARIETY OF HEALTH AND SAFETY PROGRAMS TO REDUCE UNINTENTIONAL INJURIES AMONG CHILDREN. WE OFFER PROGRAMS AT THE HOSPITAL OR AT YOUR FACILITY.VITAHLS VALLEY INITIATIVE TO ADVANCE HEALTH & LEARNING IN SCHOOLS GRIFFIN HOSPITAL HAS BEEN EXPANDING ITS REACH INTO THE COMMUNITY LIKE NEVER BEFORE.IN ADDITION TO PROVIDING HEALTH INFORMATION AND SERVICES TO THE PUBLIC AT THE HOSPITAL AND OTHER SATELLITE LOCATIONS, GRIFFIN TAKES THESE ACTIVITIES INTO THE COMMUNITIES WHERE PATIENTS LIVE, WORK, AND WORSHIP. BY OFFERING A VARIETY OF SUPPORT GROUPS, TRAINING SESSIONS, EDUCATIONAL PROGRAMS, AND OTHER COMMUNITY-BASED RESOURCES AND ACTIVITIES, AND COLLABORATING WITH OTHER NON-PROFIT ORGANIZATIONS AND GOVERNMENT ENTITIES, GRIFFIN HAS EXTENDED ITS MISSION "TO PROVIDE LEADERSHIP TO IMPROVE THE HEALTH OF THE COMMUNITY SERVED" FAR BEYOND THE HOSPITAL'S WALLS. SPECIAL PROGRAMS WERE HELD ON THE FOLLOWING TOPICS AT LOCAL CHURCHES, LIBRARIES, HOSPITAL, SENIOR CENTERS AND PRIVATE COMPANIES: MONTHLY ACP -ACCOUNTABLE CARE PLANNING, ACCESS HEALTH ASSISTANCE, BREAST WELLNESS, DIABETES EDUCATION FALL PREVENTION, TRANSPORTING CHILDREN WITH SPECIAL NEEDS INSTRUCTOR CLASS, AARP SAFE DRIVING, CHILD PASSENGER SAFETY CONFERENCE, LIVER DISEASE EDUCATION, VOLUNTEER PARISH NURSES FROM NUMEROUS DIFFERENT PARISHES AFFILIATED WITH THE VPNP AT GRIFFIN HOSPITAL PARTICIPATED FOR THE PROGRAM YEAR. CONTACTS INCLUDED OFFICE HOUR VISITS, HOME, HOSPITAL AND NURSING HOME VISITS, PHONE CALLS, AND BULLETIN DELIVERIES, HEALTH AND WELLNESS PROGRAMS WERE HOSTED AT THE VARIOUS CHURCHES. GRIFFIN HOSPITAL COMMUNITY VAN VISITED MANY COMMUNITY SITES CONSISTING OF LOCAL CHURCHES, FOOD BANKS, SHELTERS AND SHOPPING AREAS AND THE VALLEY PARISH NURSE PROGRAM COMPLETED A SIGNIFICANT NUMBER OF SCREENINGS THROUGHOUT THE YEAR.COMMUNITY OUTREACH MEETINGS WERE HELD WITH LOCAL BOARD OF DIRECTORS, HEALTH DEPTS., HEALTH CARE COUNCILS, PARISH NURSING, SAFE KIDS, CANCER COMMITTEES, AND WOMEN MAKING A DIFFERENCE. ACO STEERING ACP, QUARTERLY AHA, ANSONIA EARLY CHILDHOOD COUNCIL, BOYS & GIRLS CLUB BOARD- SHELTON, CANCER COMMITTEE, CHA- COMMUNITY HEALTH GROUP, CT COALITION OF DIABETES EDUCATOR, CT COUNCIL OF PARISH NURSE, KOMEN, DERBY DIABETES PREVENTION TASK FORCE, EARLY CHILDHOOD COUNCIL COORDINATOR, CT DIABETES PARTNERSHIP, PASTORAL CARE, SAFE KIDS, STATE DEPT. HEALTH IMPROVEMENT, PLAN VALLEY CARES, ALLIANCE VALLEY CARE, GIVERS VALLEY COUNCIL, HEALTH/HUMAN SERVICES, VALLEY HEALTHCARE COUNCIL, VALLEY PARISH NURSES, VALLEY COUNCIL YOUTH COMMITTEE, VITAHLS, VSAAC WOMEN HEART WELLNESS, WOMEN MAKING A DIFFERENCE, EARLY CHILDHOOD COUNCIL.GRIFFIN HELD CHILDREN'S PROGRAMS THROUGHOUT THE YEAR. CHILDREN'S EDUCATION PROGRAMS INCLUDED CPR EDUCATION, POISON EDUCATION, HALLOWEEN HOME, FIRE 911, GERMS, WINTER, PETS, NUTRITION, EXERCISE, SPORTS, SUMMER, WATER AND PEDESTRIAN CROSSING. SUPPORT GROUPS OFFERED THROUGH GRIFFIN HOSPITAL VALLEY PARISH NURSE, CANCER CENTER AND PASTORAL CARE WERE HELD. SUPPORT GROUPS INCLUDED ALZHEIMER CAREGIVERS, DIABETES, HEAL, MULTIPLE SCLEROSIS, FIBROMYALGIA, VALLEY HEART CLUB, PASTORAL CARE BEREAVEMENT GROUP, VOICES OF HOPE, LOOK GOODFEEL BETTER, AND CIRCLE OF FRIENDS. GRIFFIN HOSPITAL SUPPLIED COMMUNITY ASSISTANCE THROUGH THE WALK RUN 5K FUNDRAISING EVENT THAT SUPPLIED THE FUNDS TO ASSIST OUR COMMUNITY CANCER PROGRAMS SUCH AS LOOK GOODFEEL BETTER, VOICES OF HOPE AND ASSISTANCE FOR WIGS AND SUPPLIES, TREATMENT, TRANSPORTATION, SEYMOUR PINK EXERCISE TRAINOR, AFTER THE STORM MASSAGE THERAPY SERVICES AND CIRCLE OF FRIENDS. GRIFFIN HOSPITAL HOSTS WONDERLAND OF TREES PROGRAM WHICH SUPPORTS EMPLOYEES TIME TO RAISE MONEY IN THE HOSPITAL WITH A CHRISTMAS TREE RAFFLES AND EASTER RAFFLES WERE THE MONEY IS DONATED TO SPOONER HOUSE FOOD SHELTER IN SHELTON, CT.
PART VI, LINE 6:	THE GRIFFIN HOSPITAL IS PART OF AN INTEGRATED HEALTH SYSTEM WHICH INCLUDES THE FOLLOWING ENTITIES:GRIFFIN HEALTH SERVICES CORPORATION - HOLDING COMPANYGRIFFIN FACULTY PHYSICIANS, INC. - MEDICAL/EDUCATIONGRIFFIN HOSPITAL DEVELOPMENT FUND - FUNDRAISINGPLANETREE INTERNATIONAL, INC. - EDUCATION
PART VI, LINE 7:	GRIFFIN HOSPITAL OPERATES IN THE STATE OF CONNECTICUT WHICH DOES NOT REQUIRE FILING OF A COMMUNITY BENEFIT REPORT. IF FILING WAS REQUIRED, THE HOSPITAL WOULD COMPLY.

Schedule H (Form 990) 2018

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Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
GRIFFIN HOSPITAL

Employer identification number
06-0647014

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1) TEAM INC 30 ELIZABETH STREET DERBY,CT06418	06-0835182	501(C)(3)	60,254				COMMUNITY ASSISTANCE

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2018

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference	Explanation
PART I, LINE 2:	THE HOSPITAL IS NOT A GRANT MAKING ORGANIZATION BUT DOES MAKE DONATIONS TO LOCAL TAX-EXEMPT ORGANIZATIONS FOR USE IN THEIR EXEMPT PURPOSE.

Schedule I (Form 990) 2018

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

GRIFFIN HOSPITAL

Employer identification number

06-0647014

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2018

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1FREDERICK BROWNE MD TRUSTEE	(i) (ii)	0 ------------- 407,920	0 ------------- 48,141	0 ------------- 1,722	0 ------------- 8,250	0 ------------- 24,782	0 ------------- 490,815	0 ------------- 0
2PATRICK A CHARMEL CEO/PRESIDENT, BOD SECRETARY/TREASUR	(i) (ii)	514,399 ------------- 0	106,145 ------------- 0	1,722 ------------- 0	8,250 ------------- 0	24,782 ------------- 0	655,298 ------------- 0	0 ------------- 0
3KENNETH J DOBULER MD TRUSTEE/PHYSICIAN	(i) (ii)	334,223 ------------- 0	2,878 ------------- 0	0 ------------- 0	8,250 ------------- 0	0 ------------- 0	345,351 ------------- 0	0 ------------- 0
4ALEXANDER S BALKO CFO/VP FINANCE	(i) (ii)	180,061 ------------- 0	0 ------------- 0	859 ------------- 0	5,385 ------------- 0	11,875 ------------- 0	198,180 ------------- 0	0 ------------- 0
5MARGARET DEEGAN VP	(i) (ii)	208,033 ------------- 0	29,278 ------------- 0	1,573 ------------- 0	6,108 ------------- 0	24,278 ------------- 0	269,270 ------------- 0	0 ------------- 0
6TODD LIU VP	(i) (ii)	189,904 ------------- 0	21,832 ------------- 0	1,456 ------------- 0	5,587 ------------- 0	24,782 ------------- 0	243,561 ------------- 0	0 ------------- 0
7BARBARA STUMPO VP	(i) (ii)	199,891 ------------- 0	28,202 ------------- 0	1,517 ------------- 0	6,122 ------------- 0	24,782 ------------- 0	260,514 ------------- 0	0 ------------- 0
8KATHLEEN MARTIN VP	(i) (ii)	182,494 ------------- 0	28,110 ------------- 0	1,385 ------------- 0	5,551 ------------- 0	24,782 ------------- 0	242,322 ------------- 0	0 ------------- 0
9BENJAMIN ZIGUN PHYSICIAN	(i) (ii)	311,155 ------------- 0	0 ------------- 0	1,722 ------------- 0	8,144 ------------- 0	24,782 ------------- 0	345,803 ------------- 0	0 ------------- 0
10STEPHEN MORDECAI PHYSICIAN	(i) (ii)	166,642 ------------- 0	3,391 ------------- 0	1,286 ------------- 0	5,060 ------------- 0	24,782 ------------- 0	201,161 ------------- 0	0 ------------- 0
11MIHAELA BORAN PHYSICIAN	(i) (ii)	198,142 ------------- 0	0 ------------- 0	1,461 ------------- 0	6,249 ------------- 0	22,029 ------------- 0	227,881 ------------- 0	0 ------------- 0
12NUMAN GHARAIBEH PHYSICIAN	(i) (ii)	246,629 ------------- 0	0 ------------- 0	1,325 ------------- 0	6,480 ------------- 0	20,082 ------------- 0	274,516 ------------- 0	0 ------------- 0
13ADAM DWORKIN VP	(i) (ii)	170,178 ------------- 0	24,176 ------------- 0	1,314 ------------- 0	5,247 ------------- 0	24,782 ------------- 0	225,697 ------------- 0	0 ------------- 0
14MARK O'NEILL RESIGNED 62918 FORMER CFO/VP FINANCE	(i) (ii)	216,677 ------------- 0	37,974 ------------- 0	895 ------------- 0	4,113 ------------- 0	1,114 ------------- 0	260,773 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2018

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation

Schedule J (Form 990) 2018

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
GRIFFIN HOSPITAL

Employer identification number
06-0647014

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	CHEFA SERIES E	06-0806186		01-20-2017	40,652,000	RETIREMENT OF EXISTING DEBT		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	40,652,000
4 Gross proceeds in reserve funds .............	3,957,357
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............	36,768,665
7 Issuance costs from proceeds ...............	739,692
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............	2,500,000
10 Capital expenditures from proceeds .............
11 Other spent proceeds .............	4,601,000
12 Other unspent proceeds .............
13 Year of substantial completion .............	2017
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....	X
15 Were the bonds issued as part of an advance refunding issue? .....		X
16 Has the final allocation of proceeds been made? ..........	X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2018

Page 2

Part Ⅲ

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? .............		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........
6 Total of lines 4 and 5 .............
7 Does the bond issue meet the private security or payment test? ...		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X
b Exception to rebate? ........		X
c No rebate due? .........		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........

Schedule K (Form 990) 2018

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference	Explanation

Schedule K (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

GRIFFIN HOSPITAL

Employer identification number

06-0647014

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2018

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) GREGORY BORIS DO	TRUSTEE	489,707	SEE BELOWGRIFFIN HOSPITAL RETAINED THE SERVICES OF CONNECTICUT EMERGENCY MEDICINE SPECIALISTS TO OVERSEE THE EMERGENCY DEPARTMENT. GREGORY BORIS IS THE DIRECTOR OF THE EMERGENCY DEPARTMENT.		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

GRIFFIN HOSPITAL

Employer identification number

06-0647014

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 7A	THE BOARD OF TRUSTEES MAKES RECOMMENDATIONS TO THE INCORPORATORS OF THE HOSPITAL REGARDING NOMINATIONS OF MEMBERS OF THE COMMUNITY TO SERVE AS TRUSTEES.
FORM 990, PART VI, SECTION B, LINE 11B	FORM 990 IS REVIEWED BY MANAGEMENT PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12C	EACH YEAR ALL MEMBERS OF THE HOSPITAL BOARD, OFFICERS, DIRECTORS, AND KEY EMPLOYEES RECEIVE, SIGN, AND SUBMIT A CONFLICT OF INTEREST DISCLOSURE. THE DISCLOSURES ARE REVIEWED BY THE HOSPITAL BOARD AND DOCUMENTED IN THE MINUTES. ANY DISCLOSURE OF A CONFLICT PREVENTS THE INDIVIDUAL FROM INVOLVEMENT WITH OR PARTICIPATION IN SUBJECT MATTER THAN MIGHT AFFECT THE DISCLOSED CONFLICT. ALL CONFLICTS ARE DISCLOSED AT THE ANNUAL MEETING.
FORM 990, PART VI, SECTION B, LINE 15	THE COMPENSATION COMMITTEE WHICH IS A SUBCOMMITTEE OF THE BOARD OF DIRECTORS REVIEWS INDIVIDUAL COMPENSATION OF THE CEO, OFFICERS, AND OTHER MEMBERS OF SENIOR STAFF, WHOSE COMPENSATION IS REPORTABLE ON FORM 990 ON AN ANNUAL BASIS. COMPENSATION OF OTHER MEMBERS OF THE ORGANIZATION ARE APPROVED AS A PART OF THE ANNUAL BUDGET PROCESS. THE PROCESS INCLUDES THE PROCUREMENT OF COMPARABILITY DATA FROM EXTERNAL INDEPENDENT SOURCES AND OTHER INDUSTRY SPECIFIC COMPENSATION DATA. THE COMPENSATION COMMITTEE THEN MAKES A RECOMMENDATION TO THE BOARD OF DIRECTORS FOR THEIR REVIEW AND ACTION.
FORM 990, PART VI, SECTION C, LINE 19	THE GOVERNING DOCUMENTS ARE FILED WITH THE OFFICE OF HEALTH CARE ACCESS AND ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9:	TRANSFERS BETWEEN AFFILIATES -7,419,871. MINIMUM PENSION LIABILITY ADJUSTMENT -14,860,029. CHANGE IN NET ASSETS OF AFFILIATE 1,344,621. CHANGE IN BENEFICIAL INTEREST IN TRUSTS -57,444. CHANGE IN FAIR VALUE OF INTEREST RATE SWAPS -1,139,874.
FORM 990, PART XII, LINE 2C:	THE BOARD OF TRUSTEES OF GRIFFIN HOSPITAL IS RESPONSIBLE FOR SELECTING AN INDEPENDENT AUDIT FIRM AND FOR OVERSEEING THE FINANCIAL STATEMENT PREPARATION PROCESS. THERE HAVE BEEN NO CHANGES IN THESE PROCEDURES SINCE THE PRIOR YEAR.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

GRIFFIN HOSPITAL

Employer identification number

06-0647014

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)GRIFFIN HEALTH SERVICES CORPORATION 130 DIVISION STREET DERBY,CT06418 22-2560257	HOLDING COMPANY	CT	501(C)(3)	LINE 12B, II	N/A		No
(2)GRIFFIN FACULTY PHYSICIANS INC 130 DIVISION STREET DERBY,CT06418 06-1463147	MEDICAL/EDUCATION	CT	501(C)(3)	LINE 11	GRIFFIN HOSPITAL	Yes
(3)GRIFFIN HOSPITAL DEVELOPMENT FUND 130 DIVISION STREET DERBY,CT06418 22-2560254	FUNDRAISING	CT	501(C)(3)	LINE 12B, II	GRIFFIN HEALTH SERVICES CORPORATION		No
(4)PLANETREE INTERNATIONAL INC 130 DIVISION STREET DERBY,CT06418 06-1505284	EDUCATION	CT	501(C)(3)	LINE 11	GRIFFIN HEALTH SERVICES CORPORATION		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2018

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No
(1) GH VENTURES INC 130 DIVISION STREET DERBY,CT06418 22-2560247	RENTAL REAL ESTATE	CT	N/A	C				No
(2) HEALTHCARE ALLIANCE INSURANCE CO LTD 171 ELGIN AVENUE GEORGETOWN,GRAND CAYMAN CJ	OFFSHORE CAPTIVE INSURANCE	CJ	N/A	C				No
(3) CT PRACTICE MANAGEMENT INC 130 DIVISION STREET DERBY,CT06418 06-1152819	INACTIVE	CT	N/A	C				No

Schedule R (Form 990) 2018

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

Yes

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

Yes

e Loans or loan guarantees by related organization(s) ............................

Yes

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

Yes

s Other transfer of cash or property from related organization(s) ............................

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved
(1) GRIFFIN FACULTY PHYSICIANS INC	R	7,089,032
(2) GRIFFIN FACULTY PHYSICIANS INC	M	2,542,660

Schedule R (Form 990) 2018

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2018

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2018

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO PROVIDE PERSONALIZED, HUMANISTIC, CONSUMER-DRIVEN HEALTH CARE IN A HEALING ENVIRONMENT.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	21
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	18
5	Total number of individuals employed in calendar year 2018 (Part V, line 2a) ......	5	1,719
6	Total number of volunteers (estimate if necessary) .............	6	313
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	1,112,771
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	-152,690

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	2,549,039	1,896,762
9	Program service revenue (Part VIII, line 2g) .........	196,367,190	197,196,286
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	493,383	1,744,763
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	2,641,158	2,712,567
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	202,050,770	203,550,378
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	60,254
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	93,209,758	96,992,138
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	92,867,435	96,930,744
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	186,077,193	193,983,136
19	Revenue less expenses. Subtract line 18 from line 12.......	15,973,577	9,567,242
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	134,612,629	139,438,211
21	Total liabilities (Part X, line 26).............	127,205,132	145,825,386
22	Net assets or fund balances. Subtract line 21 from line 20.....	7,407,497	-6,387,175

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 142,145,657 including grants of $ 60,254 ) (Revenue $ 191,457,442 )
	GRIFFIN HOSPITAL IS AN ACUTE CARE HOSPITAL PROVIDING MEDICAL CARE TO PATIENTS IN COMMUNITIES SERVED, INCLUDING SUBSIDIZED CARE, CHARITY CARE, AND EDUCATIONAL SERVICES TO HEALTH PROFESSIONALS TO HELP PREPARE THE NEXT GENERATION OF CAREGIVERS.

4b	(Code: ) (Expenses $ 3,991,757 including grants of $ ) (Revenue $ 2,241,671 )
	PROVIDE PSYCHIATRIC SERVICES TO THE COMMUNITY ON AN OUTPATIENT BASIS.

4c	(Code: ) (Expenses $ 1,715,286 including grants of $ ) (Revenue $ 4,407,685 )
	PROVIDE CANCER RELATED RADIOLOGY SERVICES TO THE COMMUNITY.

	(Code: ) (Expenses $ 149,860 including grants of $ ) (Revenue $ 305,084 )
	PROVIDE HOSPICE SERVICES TO THE COMMUNITY.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 149,860 including grants of $ ) (Revenue $ 305,084 )
4e	Total program service expenses148,002,560

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	3,416,929	457,783	366,430

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e	1,688,362

f	All other contributions, gifts, grants, and similar amounts not included above		1f	208,400

g	Noncash contributions included in lines 1a - 1f:$
h Total. Add lines 1a-1f.......		1,896,762

		Business Code
2a	PATIENT SERVICE REVENUE	622110	185,541,753	184,479,466	1,062,287
b	STATE SUPPLEMENTAL REVENUE	900099	9,787,658	9,787,658
c	OTHER PROGRAM SERVICES	621500	1,141,380	1,141,380
d	TUITION/EDUCATION REVENUE	900099	725,495	725,495
e
f	All other program service revenue.
g	Total. Add lines 2a–2f ....		197,196,286

3 Investment income (including dividends, interest, and othersimilar amounts) ......			642,749			642,749
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		328,234
b	Less: rental expenses		0
c	Rental income or (loss)		328,234
d	Net rental income or (loss)......			328,234			328,234
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		4,385,960
b	Less: cost or other basis and sales expenses		3,283,946
c	Gain or (loss)		1,102,014
d	Net gain or (loss).....			1,102,014			1,102,014
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	CAFETERIA INCOME		900099	1,118,253			1,118,253
b	OTHER INCOME		900099	683,268	632,784	50,484
c	REBATES		900099	582,812	582,812
d	All other revenue ....
e	Total. Add lines 11a–11d ......			2,384,333
12	Total revenue. See Instructions......			203,550,378	197,349,595	1,112,771	3,191,250

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	60,254	60,254
2	Grants and other assistance to domestic individuals. See Part IV, line 22
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16.
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	2,514,964	364,923	2,150,041
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	70,961,187	60,855,375	10,105,812
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	426,693	382,973	43,720
9	Other employee benefits .......	17,430,875	14,640,404	2,790,471
10	Payroll taxes ...........	5,658,419	4,710,402	948,017
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	221,013		221,013
c	Accounting ...........	259,752		259,752
d	Lobbying ...........	18,717		18,717
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	10,859,829	6,889,553	3,970,276
12	Advertising and promotion ....	1,134,639	223,984	910,655
13	Office expenses .......	3,898,375	3,021,932	876,443
14	Information technology ......	1,191,817	332,542	859,275
15	Royalties ..
16	Occupancy ...........	3,564,653	2,171,819	1,392,834
17	Travel ............	271,467	77,307	194,160
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	2,550,116	1,983,879	566,237
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	4,584,227	3,561,990	1,022,237
23	Insurance ...	3,697,539	2,859,645	837,894
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL & DRUG SUPPLIES	32,399,000	32,399,000
b	STATE HOSPITAL TAX EXP	14,913,556		14,913,556
c	PHYSICIAN FEES	5,287,004	4,352,657	934,347
d	BAD DEBTS	3,038,213	3,038,213
e	All other expenses	9,040,827	6,075,708	2,965,119
25	Total functional expenses. Add lines 1 through 24e	193,983,136	148,002,560	45,980,576	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			1,464	1	1,471
2	Savings and temporary cash investments .........			14,468,519	2	18,920,265
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			14,451,556	4	16,597,665
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L .............
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L ..............
					6
7	Notes and loans receivable, net ....				7
8	Inventories for sale or use ........			2,226,192	8	1,832,472
9	Prepaid expenses and deferred charges ......			1,557,480	9	1,939,730
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	176,972,147
b	Less: accumulated depreciation	10b	116,027,660	60,616,320	10c	60,944,487
11	Investments—publicly traded securities .			10,368,783	11	8,743,372
12	Investments—other securities. See Part IV, line 11 .....			3,796,018	12	3,738,574
13	Investments—program-related. See Part IV, line 11 ..			10,916,649	13	12,075,663
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			16,209,648	15	14,644,512
16	Total assets. Add lines 1 through 15 (must equal line 34)...			134,612,629	16	139,438,211

17	Accounts payable and accrued expenses .....	23,928,878	17	31,377,692
18	Grants payable ...		18
19	Deferred revenue .........	1,021,050	19	690,516
20	Tax-exempt bond liabilities .........	40,652,000	20	40,652,000
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..		22
23	Secured mortgages and notes payable to unrelated third parties ..	5,573,000	23	3,989,000
24	Unsecured notes and loans payable to unrelated third parties ..	327,052	24	6,000,000
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	55,703,152	25	63,116,178
26	Total liabilities. Add lines 17 through 25..	127,205,132	26	145,825,386

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	-1,662,465	27	-15,523,747
28	Temporarily restricted net assets ...........	3,113,683	28	3,237,736
29	Permanently restricted net assets	5,956,279	29	5,898,836
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	7,407,497	33	-6,387,175
34	Total liabilities and net assets/fund balances ........	134,612,629	34	139,438,211